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Gummy Breast Implants
See if the new teardrop silicone implants are right for you.

Implant Information
Detailed breast implant information is available for all Natrelle breast implants. Please read more.

Breast Implants
Selecting the correct breast implants is a critical decision for a successful breast augmentation.

Computer Simulations
3-D computer simulations allow women to see how their breasts may look with various size breast implants.

Subglandular placement
Subglandular placement

This image shows in cross-section a breast implant in the subglandular space, above the pectoralis major muscle.

Subpectoral placement
Subpectoral placement

Illustration of subpectoral implant placement

This image shows the breast in cross-section with a breast implant in the subpectoral space, under the pectoralis major muscle. Note that the muscle does not cover the lower part of the implant. The implant is held in position at the base of the breast with the support of the skin and fatty connective tissue, not the muscle.

Dual plane
Dual plane

illustration of dual-plant breast implant placement

This example of a mastopexy and breast augmentation demonstrates a dual-plane approach to the soft tissue coverage over a breast implant. On the right, the pectoralis major muscle has been released at the base of the breast and has retracted upward. In time, after the implant has settled into the base of the breast, only the upper third of the implant will be covered with muscle and the lower two-thirds of the implant will be covered with breast tissue and fat. The implant coverage with the muscle is adjusted on a case-by-case basis depending of the anatomy of each breast augmentation patient.

Implant placement above and under
Implant placement above and under

Illustration of breast implant placement

On the left, the breast implant is shown above the pectoralis major muscle. On the right, the implant is under the pectoralis major muscle. Note that the muscle on the right is cut or "released". This allows the implant to settle nicely to the base of the breast. Also note that the outer part of the breast implant on the right has no muscle coverage.

Breast fold with implants in a good position
Breast fold with implants in a good position

Breast augmentation through the breast fold approach with the implants in a good position.

Silicone breast implant insertion
Silicone breast implant insertion
On the right, an empty saline implant is placed through the breast fold. The left side shows a breast implant in position.
Silicone gel implant insertion
Silicone gel implant insertion

illustration of silicone gel breast implant insertion

A silicone implant is inserted at the base of the breast. The pink area on the left side shows the sub-pectoral "pocket" that is surgically created for the implant. The right side shows the incision and the pectoralis major muscle. Breast implants are usually placed under the pectoralis major muscle.

Breast augmentation incision
Breast augmentation incision

illustration of breast augmentation incision options

Breast implants are placed through three incisions. A. Axillary, or underarm, approach. B. Areolar approach. C. Inframammary, or breast fold, approach.

Breast fold augementation
Breast fold augementation

Choosing an Incision

illustration of breast augmentation incision options

Breast implants are placed through three incisions. A. Axillary, or underarm, approach. B. Areolar approach. C. Inframammary, or breast fold, approach.

So which breast augmentation approach is best for you?

This is a very personal decision, and mostly depends on the aesthetics you are trying to achieve.

Some women prefer the breast fold or areolar scars because those are always hidden with clothing, even with a small bikini top.

Other women choose the axillary approach to avoid scars on the breast that may be visible while looking at the breasts in a mirror or during intimate encounters.

For the most part, beautiful results can be achieved with each incision and with low risks. So, we recommend that you make this decision mostly based on how you want to look and feel with your breast augmentation.

To help you with this process, we have created the following table with a number of important advantages and disadvantages of each breast augmentation approach for you to consider:

Axillary Endoscopic

Advantages
  1. No scar on the breast
  2. Scar often blends into skin crease well and is hard to detect
  3. Usually least visible of augmentation scars
  4. Endoscopic technique provides full visibility and precise surgical control of pocket creation, bleeding and implant placement
Disadvantages
  1. A poor scar (which is not typical) may be visible in sleeveless tops
  2. Limited in treatment of some cases of mildly sagging or tuberous breasts.
  3. The longer (2-2.5 inches) scar needed for placement of silicone gel implants can be difficult to hide in small underarms.
  4. Additional surgery, such as removal of scar tissue from around the implant (capsulectomy), may be difficult with this approach.
  5. Very small risk of numbness of the skin around the underarm and upper arm.
  6. Risk of scar tissue band formation under the axillary scar. But, if this occurs it usually resolves spontaneously over time.

Breast Fold

Advantages
  1. Direct visibility of pocket creation and implant positioning.
  2. In patients with deep folds, the scar is hidden by the breast.
  3. Good approach for additional breast surgery.
  4. Good approach for treatment of cases of mildly sagging or tuberous breasts.
  5. Excellent access for placement of silicone gel implants.
Disadvantages
  1. Scar on the breast.
  2. Hard to hide scar on small, tight breasts, without deep folds.
  3. Scar may be visible when you are lying flat.

Areolar

Advantages
  1. Direct visibility of pocket creation and implant positioning.
  2. Scar may be well hidden by areolar tissue.
  3. Good approach for additional breast surgery.
  4. Good approach for treatment of cases of mildly sagging or tuberous breast.
Disadvantages
  1. Most women do not want this sensitive area operated on.
  2. Scar is often visible and is at the focal point of the breast.
  3. Exposes the implant to breast tissue and bacteria within the breast tissue.
  4. Implant exposure to bacteria increases the risk of capsular contracture.
  5. Some sensory nerves around the areola are cut. (However, increased risk of loss of nipple sensation with this approach has not been scientifically proven).
  6. Greatest risk of problems with future breast feeding.

Umbilical *

* Not performed by Dr. Connall and not approved by the implant manufacturers
Advantages
  1. No scar on the breast
Disadvantages
  1. Blind, blunt pocket creation
  2. Silicone gel implants cannot be placed though this approach
  3. Precise creation of pocket difficult
  4. Precise control of bleeding difficult
  5. Precise implant positioning difficult